Stanford Researchers Set Out to Save Discarded Donor Hearts

Stanford Medicine
December 10, 2021

Kiran Kaur Khush, MD, is a heart failure cardiologist at Stanford Medicine. As a professor of cardiovascular medicine, Dr. Khush focuses on clinical and translational research in the field of heart transplantation.

Each year, fewer than 10% of people who need a heart transplant receive this lifesaving surgery. A shortage of donor hearts is one obstacle, but there is another, lesser-known barrier. Nearly two-thirds of available donor hearts are discarded, never making it into a surgeon's hands.

Stanford Medicine cardiologist Kiran Kaur Khush, MD, set out to discover why so many donor hearts were going unused. She and fellow researchers spearheaded the groundbreaking Donor Heart Study, the largest study ever conducted on donor heart acceptance for transplantation. The results of this research could significantly increase the number of successful heart transplants performed, saving countless lives.

Recognizing a Need for Defined Donor Heart Criteria

Khush began her research with a review of current standards for accepting donor hearts, which revealed overly conservative measures and inconsistencies. "The criteria for accepting donor hearts for transplant are decades old and lack evidence-based guidelines," said Khush. "One transplant center might accept a certain donor heart, while another may reject it. We also see an overall trend toward discarding more donor hearts, when more people than ever need them."

Previous studies have failed to demonstrate consistent links between recipient outcomes and the characteristics and cardiac function of their donor heart. For example, some hearts are rejected because of smaller size or donor age, yet these factors alone do not determine the recipient's long-term results. Khush and her team recognized the critical need to standardize which donor hearts can be used for transplants-and which ones to let go.

Paving New Paths Toward Safe Heart Transplantation

Stanford Medicine's Donor Heart Study is unlike any study done before. The National Institutes of Health (NIH) sponsored the study, which had three primary goals:

– Identify reliable measures of cardiac function in potential heart transplant donors

– Prospectively study reasons for non-acceptance of donor hearts

– Develop evidence-based clinical tools for transplant centers, empowering them to make real-time decisions about donor heart acceptance

The five-year prospective study collected data on nearly 4,500 donors managed by eight organ procurement organizations (OPOs) across the U.S. Enrollment is complete, and researchers are currently analyzing and processing the data.

"We submitted our first analyses as an abstract to the International Society for Heart and Lung Transplantation Annual Meeting & Scientific Sessions," said Khush. "Our first manuscript is being written, with hopefully many more to follow."

Clear Guidelines, More Beating Hearts

Specific and proven criteria are necessary to ensure donor hearts are appropriate for transplantation. Stanford Medicine cardiac experts agree that established standards for donor hearts will benefit patients now and for years to come.

"Hopefully, as our understanding of donor hearts grows, we can potentially offer more transplants to more patients," said Jeffrey Teuteberg, MD, section chief of heart failure, cardiac transplant and mechanical circulatory support at Stanford Medicine. "It is fitting that Stanford led a national effort to study donor hearts given Stanford's history of pioneering work in the field of heart transplantation. Dr. Khush's work will clearly advance the field and give more confidence and clarity to heart transplant centers when matching donors to patients."

Respected Leaders in Heart Transplantation

Stanford Health Care is the fourth-largest transplant program in the country, thanks to our skilled surgeons and consistently positive outcomes. Our passion for transplantation extends seamlessly from the lab to the operating room, as we continue to increase success rates and accessibility. Some of our recent advances include:

– Noninvasive rejection tests: We are leaders in early detection of graft injury through gene-expression profiling and donor-derived cell-free DNA. Our advanced blood tests detect early signs of rejection without the need for an invasive biopsy.

– Breakthroughs in previously rejected heart donations: We can accept more heart donations by delivering highly effective antiviral therapies to recipients who receive a heart from a hepatitis C-positive donor.

– Leading-edge organ preservation: We use a novel device that provides a sterile, temperature and pressure-controlled environment for donor hearts. Stanford Health Care is among a select few transplant programs in the country to use this technology, which extends the organ's survival time. Learn more about our advanced Cardiac Transport System (CTS).

Read more about Stanford Medicine's Donor Heart Study. For more information, contact Helen Luikart, RN, heart transplant clinical trial manager, at luikart@stanford.edu.

Learn more about Stanford's Heart Transplant Program. We continue to be recognized as a top-ranked heart transplant hospital for our high volumes, innovations, and expertise. Stanford Health Care is ranked among the nation's top 10 Cardiology & Heart Surgery programs.